In a sliding (extraperitoneal) inguinal hernia, the caecum forms part of the wall of the hernial sac itself. Which anatomical fact explains this arrangement?
- A The caecum is retroperitoneal, so it cannot be fully invested by peritoneum of the sac ✓
- B The caecum is intraperitoneal and mobile on a mesentery
- C The caecum is covered by visceral peritoneum that fuses with transversalis fascia at the deep ring
- D The caecum is attached to the anterior abdominal wall by the phrenicocolic ligament
Correct answer: A. The caecum is retroperitoneal, so it cannot be fully invested by peritoneum of the sac
Explanation
The caecum and ascending colon are retroperitoneal, lacking a complete peritoneal investment. When such a fixed retroperitoneal organ protrudes through the abdominal wall, it drags peritoneum incompletely and becomes incorporated into the sac wall rather than hanging free within it. The phrenicocolic ligament relates to the splenic flexure, so option D describes a different region entirely.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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